Digital Commons Network^™

Cannabis Caught Between Smoke And Mirrors, Laura M. Olivieri Robles

Capstones

Cannabis legalization advances across the country and social attitudes are changing. Public health experts see parallels with the tobacco industry-- and are concerned about kids exposed to cannabis advertisement.

Offset: How The Government Improperly Takes Money From The Disabled, Carmen Reinicke

Capstones

The US Department of Education is supposed to use its computers to match its borrowers who now suffer from total permanent disabilities based on Social Security or Veteran Administration rolls. If the borrower has been disabled for more than five consecutive years, then deductions for unpaid student loans are supposed to cease.

A report from the U.S. Government Accountability Office, a federal agency that reviews government work, shows that the program, now a computerized system that matches Social Security numbers, fails to identify thousands of individuals who deserve student debt relief.

Link: https://medium.com/@careinicke/offset-how-the-government-improperly-takes-money-from-the-disabled-8928cd556f93

Sleep Paralysis: Dreams, Demons And Rem-Atonia, Joshua G. Christensen

Capstones

Have you ever woken up from a dream only to find you can’t move? You’re paralyzed and, sometimes, you are even having vivid hallucinations. It’s terrifying, but harmless and very common. Regardless of it being so innocuous, Sleep Paralysis has inspired fear for centuries and many still believe it to be a supernatural phenomenon. This is, most likely, because most people who get Sleep Paralysis, don’t really know what it is. People just like me.

https://medium.com/@joshua.christensen/sleep-paralysis-dreams-demons-and-rem-atonia-27f46c2748cf

Teen Pregnancy Prevention Programs Pick Up The Pieces After Defunding Scare, Camille Danielle Smith

Capstones

The Trump administration attempted to cut $200 million dollars from the Obama administration’s Teen Pregnancy Prevention Programs. About 81 TPP programs across the U.S. would have had their funding end in June of 2018 instead of the original end date of June 2020. Many organizations sued the Department of Health and Human Services and the courts ruled the cuts illegal and ensured the funding until 2020. But now many programs across the U.S. are trying to cope with life after the defunding scare.

Link to capstone project: https://medium.com/@camille.smith/teen-pregnancy-prevention-programs-picking-up-the-pieces-after-de-funding-scare-6dd2f7ab00bf

The New World Of Pet Prosthetics, Anna Brooks

Capstones

When an abandoned dog was found in Brooklyn with his paw gnawed off, the animal shelter had two options: amputate the leg, or put the dog down. But neither seemed like a solution. So they decided to do something different, and fit the dog for a prosthetic leg. Prosthetics for people have been around for millennia, and now these devices are moving into the animal kingdom. This story explores the new world of animal prosthetics, and how these devices have changed the lives of animals like Mr. Stubbs — the first alligator with a prosthetic tail — and saved the …

Transgressed Bodies, Estephani Cano Martinez

Capstones

In 2005, desperate to feminize her figure, Paola Gil, a 43-year-old trans woman from Guatemala, decided to get silicone injections in her hips for $1,000. Two hours after the illegal procedure, she started vomiting and defecating blood. She ended up in a coma in the hospital for a month.

The medical record shows that Paola received a silicone injection mixed with mineral and castor oil. She still suffers serious consequences, including difficulty walking, kidney and liver failure, and depression, after seeing her body disfigured.

Because of discrimination, lack of economic resources, and misinformation, many trans women like Paola see liquid …

Politically-Connected Nonprofit Makes Millions Putting Homeless Families In Unsafe Homes, Benjamin Foldy

Capstones

A document-driven investigation into the city’s largest recipient of homelessness funds uncovered the group’s dense political connections, questionable practices regarding subcontracting to for-profit affiliated entities and systematically subpar housing provided to homeless families. https://medium.com/@ben.foldy/politically-connected-nonprofit-makes-millions-putting-homeless-families-in-unsafe-homes-309314c2eed2

Combining Patient-Centered-Care And Technology To Reduce Falls In A Medical/Telemetry Unit, Megan Mira

Master's Projects and Capstones

Abstract

PROBLEM: From October 2017 through June 2018 there were 25 patient falls recorded on the 5^th floor medical surgical telemetry unit. Top factors contributing to this high fall rate include: poor patient-centered-care planning, and inadequate set-up for use of technology.

CONTEXT: According to the Joint Commission, 2015, each fall with injury costs $14,000. This estimate doesn’t include the potential indirect costs that account for the long-term effects of injuries such as disability, dependence on others, lost time from work, household duties, and reduced quality of life.

INTERVENTIONS: Staff education was introduced and focused on using a new mindfulness …

Accessing Mental Health Services As An Undocumented Individual: Policy Recommendations For The State Of California, Lorena Mosqueda

Master's Projects and Capstones

Undocumented individuals are subject to stressors that may exacerbate existing mental health problems or proliferate new mental health illnesses. Due to unjust historical and current institutional and systemic policies the undocumented population accesses mental health services at a rate far below the general population. As a result, this vulnerable community is left with untreated mental health conditions and is further entrenched in a cycle of inequity. In an effort to address this alarming reality we based a review of relevant literature to identify recommendations to increase access to mental health services among the United States undocumented population. Additionally, a simulation …

An Innovative Discharge Intervention: A Quality Improvement Project, Yvonne Swain

Master's Projects and Capstones

Abstract

Problem: This project aims to decrease the discharge time of a patient from the hospital once the discharge order has been written. Current discharge times are averaging over 3 hours, leading to a breakdown in the patient throughput process. A patient survey was conducted to determine the reason for prolonged discharge times. The survey revealed that patients are not aware of their day of discharge, which may lead them to being discharged without transportation home. Many studies conclude that there are improvement opportunities around discharge planning and communication.

Context: This quality improvement initiative takes place in a 26-bed, medical-surgical/telemetry …

Catheter-Associated Urinary Tract Infection Reduction: A Quality Improvement Project, Wallace Kramm

Master's Projects and Capstones

Abstract

Problem: Hospital-acquired infections are preventable harm that occurs to patients while in the hospital. Catheter-associated urinary tract infection (CAUTI) is a preventable hospital-acquired infection that continues to plague hospitals nationwide. The Centers for Disease Control and Prevention estimates that there are more than 13,000 CAUTI related deaths in the United States annually (Scanlon, 2017). In addition to the harm caused to patients by CAUTIs, the estimated $500 million yearly cost for CAUTI treatment has created a fiscal burden on healthcare systems (Scanlon, 2017). Decreasing the rate of CAUTI by decreasing overall number of catheters is the goal of this …

"Improving Nursing Communication Outcomes Through The Tell-Us Card", Jillian Cule, Jeffrey Salao, Nina Park, Laura Le, Brittney Pilker, Maricarmen Reyes

Master's Projects and Capstones

Nursing communication plays a pivotal role in patient-centered care. However, statistics have shown that failures in communication exist in more than 20% of all hospital settings (Sethi & Rani, 2017). Within the explored microsystem, a gap in patient communication was identified through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Reports revealed that the microsystem was performing at 69%, which is 11% below the national average for nursing communication (Centers for Medicare and Medicaid Services [CMS], 2018). After performing a microsystem assessment, there was a measurable communication opportunity between the patients and nurses. It was determined that …

Quantifying Pre-Industrial To Mid-Late 20th Century Anthropogenic Lead, Mercury And Cadmium Pollution In Caribbean Marine Environments Using Skeletonized Sea Turtle Remains, Felicia L. Pena

Theses and Dissertations

Various lines of evidence indicate that levels of anthropogenic pollutants, such as lead, mercury and cadmium, have increased in terrestrial and atmospheric environments since the early 19th century and the advent of industrialization. While the exposure to these three trace elements is a global concern, this study focused primarily on marine environments located throughout the Caribbean. Using ICP-MS, this study aimed to detect and quantify anthropogenic pollutants, specifically lead (Pb), mercury (Hg) and cadmium (Cd), using skeletonized remains of sea turtles as biological proxies for environmental quality. Archaeologically derived (n=5) and mid-late 20th century (n=6) Hawksbill and Green turtles were …

What Role Is Neuroscience Playing In New State Raise-The-Age Laws?, Dane N. Stallone

Capstones

Several states have cited neuroscientific evidence to help justify new raise-the-age laws that raise the age at which offenders can be tried as adults. Neuroscience shows that adolescent brains continue to mature well into their 20s. How much influence neuroscience should have in determining legal policy, however, remains contested among experts.

https://theartofscienceme.wordpress.com/2019/01/05/what-role-is-neuroscience-playing-in-new-state-raise-the-age-laws/

Medication Error Prevention: Improving Patient Health Outcome, Brigitta Van Ewijk

Master's Theses

Medication administration errors were reported to have an error rate of 60% in early research mainly in the form of the wrong dose, time, or rate. Working conditions were found to be one of the main contributors to these errors. Recognizing and reporting medication errors are key to the implementation of the reduction of this critical health problem (Hughes & Blegen, 2008). DataRay Inc. (n.d.), states that almost one in five medication doses administered in hospitals is given in error. The two most common errors were (1) dispensing medicine at the wrong time (43% of incidents) and (2) omitting a …

Reexamining Overuse Of Frequent Observation For New Admissions On Psychiatric Units To Increase Nurse/Patient Engagement, Samuel Novela

Master's Theses

People in California who suffer from mental health conditions are often admitted involuntarily to hospitals on 72 hour psychiatric evaluation holds if they are deemed imminently dangerous to themselves, or others, or are gravely disabled. Observational patient safety checks are performed and based on patient acuity and hospital standards. Variations exist among different clinical settings with regard to best practices and the patient subpopulations that may warrant less frequent safety checks. Nurses experience different levels of satisfaction with regard to frequency of safety checks because there is no national consensus on which subsets of patients may require them. A senior …

Dietary Polyunsaturated Fatty Acids Regulate Mammary Tumor Growth And Metastasis By Modulating Tissue Microenvironments, Saraswoti Khadge

Theses & Dissertations

Omega (ω)-6 and ω-3 polyunsaturated fatty acids (PUFAs) are essential fatty acids (FAs) and the precursors of pro- and anti-inflammatory mediators respectively. Epidemiological studies have shown a lower incidence of breast cancer (BC) in the countries where long-chain (LC)-ω-3FAs consumption is higher; however, the role of ω-3FAs in BC growth and metastasis is poorly understood. We used isocaloric, isolipidic ω-6 and ω-3 (contains LC-ω-3FAs) diets and a pair-fed model to evaluate the effects of dietary PUFAs in mammary tumor metastasis. Our studies have resulted in several novel observations including that dietary LC-ω-3FAs modulate mammary gland (MG) microenvironments in non-tumor bearing …

An Assessment Of Preparations Made In The United States For Highly Hazardous Communicable Diseases Following The 2014-2016 Ebola Virus Disease Epidemic, Jocelyn J. Herstein

Theses & Dissertations

The 2014-2016 Ebola virus disease (EVD) epidemic in West Africa was unprecedented in magnitude and scope. The threat of imported cases of EVD in the United States prompted the Centers for Disease Control and Prevention (CDC) to establish a tiered network of hospitals to enhance domestic isolation capacity, including the designation of select hospitals as Ebola treatment centers (ETCs). As of spring 2015, no information existed on the capacity, physical infrastructure, staffing models, or infection control protocols of these newly-established ETCs, nor was there information on other highly hazardous communicable diseases (HHCDs) these units would admit. Moreover, no documentation was …

The Neuromodulatory And Hormonal Effects Of Transcutaneous Vagus Nerve Stimulation As Evidenced By Salivary Alpha Amylase, Salivary Cortisol, Pupil Diameter, And The P3 Event-Related Potential, Christopher M. Warren, Klodiana D. Tona, L. Ouwerkerk, Jeroen Van Paridon, Fenna Poletiek, Henk Van Steenbergen, Jos A. Bosch, Sander Nieuwenhuis

Psychology Faculty Publications

Background

Transcutaneous vagus nerve stimulation (tVNS) is a new, non-invasive technique being investigated as an intervention for a variety of clinical disorders, including epilepsy and depression. It is thought to exert its therapeutic effect by increasing central norepinephrine (NE) activity, but the evidence supporting this notion is limited.

Objective

In order to test for an impact of tVNS on psychophysiological and hormonal indices of noradrenergic function, we applied tVNS in concert with assessment of salivary alpha amylase (SAA) and cortisol, pupil size, and electroencephalograph (EEG) recordings.

Methods

Across three experiments, we applied real and sham tVNS to 61 healthy participants …

Lindenwood Digest, December 14, 2018, Lindenwood University

Lindenwood Digest

The Lindenwood Digest has been a digital employee newsletter since 2009.

Post-Traumatic Stress Disorder Screening Project For Adult Males From The Middle East And Afghanistan, Ricky Norwood

Master's Projects and Capstones

Current research indicates a significant rise in PTSD signs and symptoms of adult males arriving from the Middle East and Afghanistan. In an effort to increase the awareness of Post-Traumatic Stress Disorder (PTSD) in clinical personnel and adult males from the Middle East and Afghanistan, the Sacramento Refugee Health Clinic implemented a PTSD Screening Project. This project was designed to ensure the maximum number of the adult males from the Middle East and Afghanistan would be appropriately screened for PTSD and provided additional opportunities to meet the mental and acute primary care needs of these patients in an adequate and …

Examining Barriers To Receiving Home Care In A Medical Program, Mariah Martinez

Master's Projects and Capstones

Introduction: In Home Supportive Services is a Medi-Cal program serving low-income seniors and adults with disabilities. IHSS clients, or “consumers” are responsible for finding, hiring and supervising their IHSS home care worker. IHSS workers provide services such as feeding, bathing, bowel and bladder care, meal preparation and clean-up, laundry, and paramedical care. This project was created to identify why a high number of IHSS clients have not been able to hire and retain an IHSS care worker. The aim of the study was to understand the consumers interactions with IHSS and identify points at which consumers experience challenges in …

Finding The Narrative In Incident Reports, La'eeqa Aslam

Master's Projects and Capstones

The Progress Foundation, as licensed by the state of California and the Community Care Licensing, is required to use incident reports for internal audits and remain in compliance as a health facility. Incident reports are used to record events or accidents that have occurred within an organization. Often times, reports are made, handed off, and given from the residence home to the Community Care Licensing with little to no information of how an incident was managed. The Progress Foundation is working towards tracking information from the incident reports to improve internal management and understand the trends in the reports.

In …

Mdr Matters! Improving Primary Nurse Participation In Multidisciplinary Rounds, Alma Alcantara

Master's Projects and Capstones

Abstract

Problem: The current model of multidisciplinary rounds (MDR) in a 40-bed medical-surgical unit within a Northern California community hospital has demonstrated low participation rates from primary nursing. The primary nurse attendance in MDRs is consistently at 50% participation, below the target goal of 80%. This lack of engagement leads to ineffective communication and fragmented care coordination resulting in suboptimal quality care and cost outcomes.

Context: An intervention strategy to standardize the MDR model was implemented over three months. A literature review revealed that effective and consistent MDR practices can directly influence primary nurse participation. This change management project focus …

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

Health Care Improvement Initiative: Outcomes And Impact Of An Academic-Practice Partnership Between A Large Integrated Health System’S Nurse Scholars Academy And The University Of San Francisco School Of Nursing And Health Professions, Ryan Fuller

Master's Projects and Capstones

By December 2018, a large integrated health system’s Nurse Scholars Academy (NSA) will have financially-sponsored 64 registered nurses to return to school through a strategic academic-practice partnership program at the University of San Francisco (USF). Referred to as ‘Nurse Scholars,' health system employees elected to return-to-school through NSA. As a five-year initiative, NSA was at risk for not receiving additional funding beyond 2020 without a thorough outcomes analysis that articulated the outcomes to executive leadership.

This health system employs more than 23,000 registered nurses in Northern California (NCAL). The NSA is a region-wide effort to accelerate academic progression, leadership development, …

Reducing Inpatient Readmissions Through Early Follow-Up Appointment Planning: A Quality Improvement Project, Isabella Cuenco

Master's Projects and Capstones

Problem: Inpatient readmissions have a highly negative impact on healthcare systems. Not only do these hospitalizations have a detrimental effect on patient outcomes they also are accompanied by a prohibitive financial burden to the hospitals.

Context: Follow-up appointment with a primary care provider after discharge has been demonstrated as a viable strategy to reduce the risk of readmissions.

Interventions: Create a volunteer program to schedule patient appointments with a primary care provider within seven days of discharge.

Measures and Results: Compare the number of patients that were discharged with a follow-up appointment after the intervention to before the intervention, and …

Improving The Staff Responsiveness By Bundling Care, Practicing Proactive Authentic Hourly Visits, And Using The Four P’S, Robert Vega

Master's Projects and Capstones

Abstract

Problem

Staff responsiveness is an important Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Star Rating composite tool that hospitals monitor because it is consumer-driven information. The intent is that the HCAHPS composite promotes patient satisfaction, contributes to the prevention of harm, and can save millions of dollars (Danaf et al., 2017). On admission, the patient is orientated to their room, provided a nurse call light button to use, and told not to get out of bed alone and to wait for their nurse (Mitchell et al., 2014). On Three North, a gap exists in the delay it …

English For Baking: Lessons For Kitchen Workers Using On-Site Learning, Christopher Torossian

Master's Projects and Capstones

Today, the back of house staff in culinary kitchens is comprised largely by migrant workers whose native language is something other than English. At times this can create issues among workers due to communication errors or complete lack of communication all together, posing issues for not only cooking, but it can also be a threat to kitchen safety as well. Additionally, due to native speaker stigma surrounding non-native speakers of English, many workers are often denied the chance at a higher position in the workplace simply because of their low communicative competence, despite their actual talents and skills in the …

Identification Of Perioperative Barriers To Enhanced Recovery After Surgery In Colorectal Surgical Populations, Leah Marshall

Master's Projects and Capstones

Enhanced recovery after surgery (ERAS) has evolved over the past 30 years through evidence-based interventions. Enhanced recovery after surgery uses a multidisciplinary and multimodal evidence-based approach to maximize patient recovery. Perianesthesia nurses are critical to its success and have an obligation to understand and participate in the process to optimize patient outcomes. Despite proving to decrease complications and duration of stay in colorectal surgery patients without following colorectal surgery, the implementation of ERAS in colorectal pathways have been met with barriers (Alawadi et al., 2015). Subramaniam & Horgan (2016) describe ERAS pathways as evidence-based interventions that eliminate dated practices based …